THE HEART

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THE HEART
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I. GENERAL

• A. Primary Function
• pump blood through the body
• Normal functional capacity of the heart
• 100,000 heartbeats/day
• 2,760,000,000 heartbeats/lifetime
• 4,000 gallons (15,000 liters) blood
  pumped/day

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II. Cardiac Anatomy

• A. Location
• in the mediastinum of thoracic cavity between
  lungs

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II. Cardiac Anatomy

• B. Pericardium
• 1. a double-walled fibrous sac encloses
  the heart and roots of the great vessels.

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II. Cardiac Anatomy

• B. Pericardium
• 2. functions to maintain the
• - position of the heart
• - protect it from overfilling

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II. Cardiac Anatomy

• C. Pericardium
• 3. Layers

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• 3. Layers
• a. fibrous pericardium
•       resembles a bag
•       prevents over distension of the heart
•        protects
•        anchors heart to the mediastinum

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• 3. Layers
• b. serous pericardium
•       thinner inner layer
•       a smooth inner sac with lubricated
  surfaces which allow movement
•   2 layers

• parietal layer
• visceral layer (aka epicardium)

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• 3. Layers
• parietal layer
• lines the inner surface of the fibrous
  pericardium
• visceral layer (aka epicardium)
• covers the entire surface of the heart
• attached to the myocardium
• contains pericardial fluid that lubricates the
  pericardial cavity, allowing freedom of movement

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Layers of the the Pericardium
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B. Pericardium

• 4. Pericardial Cavity
• space between the parietal and visceral
  layers of the
  serous pericardium

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II. Cardiac Anatomy

• B. Pericardium
• 5. Pericarditis
• inflammation of the pericardium

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II. Cardiac Anatomy

• B. Pericardium
• 6. cardiac tamponade
• build up pericardial fluid
• bleeding into the pericardial cavity
• may result in cardiac failure

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C. Heart Wall
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C. Heart Wall
1. Epicardium visceral layer of
pericardium fused to the myocardium thin,
transparent, smooth, slippery function -
protective
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C. Heart Wall
2. Myocardium bulk of heart muscular involunta
ry striated, branched cells cells have
intercalated discs
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C. Heart Wall
2. Endocardium endothelium
connective t. smooth lines heart
and valves
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C. Heart Wall
2. Endocardium coninuous
w/ vascular endothel.
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II. Cardiac Anatomy

• C. External

Note the coronary sulcus
and interventricular sulcus
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II. Cardiac Anatomy
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III. Internal Cardiac Anatomy

• Atria
• 1. smaller, thin walled upper chambers
• 2. interatrial septum
• which exhibits fossa ovalis
• (embryonic foramen ovale)

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III. Internal Cardiac Anatomy

• Ventricles
• 1. lower, thick- walled
• 2. pump blood out of the heart
• 3. separated by the interventricular septum

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III. Internal Cardiac Anatomy

• A-V Valves
• 1. tricuspid valve
• Location
• chordae tendoneae
• papillary muscles

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III. Internal Cardiac Anatomy

• A-V Valves
• 2. Bicuspid valve
• Mitral valve
• Location
• Same attachment

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Tricuspid Valve
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III. Internal Cardiac Anatomy

• Semilunar valve
• 1. half moon shaped
• 2. pulmonary semilunar
• 3. aortic semilunar

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Semilunar Valve
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III. Internal Cardiac Anatomy

• Valve Disorders
• 1. Diseases caused by
• a. rheumatic fever
• b. birth defect
• c. damage to the papillary muscle
• d. Aging

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III. Internal Cardiac Anatomy

• Valve Disorders
• 2. When a valve becomes diseased
• they become stenosed
• or they dont close completely
• 3. Causes
• shortness of breath
• chest pain
• tiredness

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IV. Major Vessels of the Heart

1. Arteries Vs Veins

1. Arteries carry blood away blood under
great pressure flows in spurts have
thick, elastic, muscular walls lack
valves most carry oxygenated blood
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IV. Major Vessels of the Heart

1. Arteries Vs Veins

2. Veins carry toward heart blood under
low pressure flows slowly have
thin, slightly muscular walls have
valves most carry deoxygenated bld
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IV. Major Vessels of the Heart

1. The Great Vessels

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IV. Major Vessels of the Heart

1. Coronary vessels

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IV. Major Vessels of the Heart

1. Veins of the heart

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IV. Major Vessels of the Heart
Coronary Sinus Blood from the cardiac veins
empties into the coronary sinus, which then
empties into the right atrium
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IV. Major Vessels of the Heart

• Coronary Artery Disease
• any abnormal condition of the coronary
  arteries that
• interferes with the delivery of an adequate
  supply of blood to the heart muscle.

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IV. Major Vessels of the Heart

• Coronary Artery Disease
• 1. Arteriosclerosis
• arteries narrowed due to a build-up of
  fat, cholesterol and calcium
• 95 of c.a. disease

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IV. Major Vessels of the Heart

• Coronary Artery Disease
• 2. angina pectoris
• a painful, tightening, pressure or
  fullness in the chest
• results when heart muscle does not
  receive adequate oxygen 

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IV. Major Vessels of the Heart

• Coronary Artery Disease
• 2. myocardial infarction
• heart attack results from total
  occlusion of a coronary artery

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V. Blood Flow Through the Heart
A. Adult
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V. Blood Flow Through the Heart

• Fetus
• 1. Maternal blood supplies the fetus with O2
  and nutrients and carries away its wastes.

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V. Blood Flow Through the Heart

• Fetus
• 2. Adaptations of fetal blood and vascular
  system.
• fetal hemoglobin concentration about 50
  greater than in maternal blood.
• Fetal hemoglobin is slightly different
  chemically and can carry 20-30 more O2 than
  maternal hemoglobin

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VII. ELECTRICAL CONDUCTION SYSTEM

• Sinoatrial Node (SA node)
• 1. Location
• in right atrial myocardium
• 2. Function
• pacemaker

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VII. ELECTRICAL CONDUCTION SYSTEM

• Sinoatrial Node
• 3. regulated by autonomic n. s.
• 4. causes the atria to contract

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VII. ELECTRICAL CONDUCTION SYSTEM

• Atrioventricular node (AV node)
• 1. Location
• below SA node
• 2. Function
• causes ventricles to contract

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VII. ELECTRICAL CONDUCTION SYSTEM

• Atrioventricular node (AV node)
• 3. Controlled by autonomic n.s.

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VII. ELECTRICAL CONDUCTION SYSTEM

1. AV bundle (bundle of His)

carries the impulse from the AV node
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VII. ELECTRICAL CONDUCTION SYSTEM

• Conduction fibers (Purkinje fibers)
• not nerves
• modified cardiac mscle

carries the impulse into the ventricles
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Altogether Now
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VIII. ELECTROCARIOGRAM

• Basic ECG waves
• 1. P wave - generated by the firing of the SA
  node
• representing the impulse across the atria to
  the A/V Node

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VIII. ELECTROCARIOGRAM

• Basic ECG waves
• 2. QRS complex
• representing the impulse as it travels
  across the ventricles

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VIII. ELECTROCARIOGRAM

• Basic ECG waves
• 3. T wave
• representing the repolarization of the
  ventricles

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IX. Cardiac Cycle (heart beat)

• Auscultation
• 1. characteristic "lub-dup"
• 2. caused by vibrations caused by closing
  valves

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IX. Cardiac Cycle (heart beat)

• Auscultation
• 2. closing valves
• a. Lubb
• A-V valves
• b. Dub
• Semi-lunar
• valves

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IX. Cardiac Cycle (heart beat)

• Basic Terminology
• 1. Systole
• ventricular contraction
• atria relax

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IX. Cardiac Cycle (heart beat)

• Basic Terminology
• 2. Diasystole
• atrial contraction
• ventricles relax

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IX. Cardiac Cycle (heart beat)

• Basic Terminology
• 4. tachycardia (higher than normal HR)
• 5. bradycardia (lower than normal HR)

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